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Birth Outcomes, Postpartum Health and Primary Care Contacts of Immigrant Mothers in an Australian Nulliparous Pregnancy Cohort Study

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Abstract

To investigate differences and similarities in birth outcomes, postpartum health and primary care contacts of mothers born overseas of non-English speaking background (NESB) compared with Australian-born mothers. Nulliparous women were recruited in early pregnancy (≤24 weeks gestation) to a prospective pregnancy cohort study from six metropolitan public hospitals in Victoria, Australia. Analyses are based on questionnaires completed in pregnancy and at 3 months postpartum. Of the 1,507 women recruited in the study, 1,431 women (95%) were followed up at 3 months postpartum. Immigrant mothers of NESB (n = 212) and Australian born mothers (n = 1,074) had similar obstetric outcomes and postpartum physical health outcomes. Immigrant women were more likely to say they had been depressed for 2 weeks or longer since the birth (Adj OR = 1.92, 95% CI 1.3–2.8); to report relationship problems (Adj OR = 1.39, 95% CI 0.9–2.1) and to report lower emotional satisfaction with their relationship with the partner (Adj OR = 1.69, 95% CI 1.1–2.6) after adjusting for age, education status, income, method of birth and genital tract trauma. Immigrant mothers were less likely to be asked about feeling low or depressed by general practitioners (OR = 0.79, 95% CI 0.5–0.9) and about relationship problems by maternal and child health nurses (OR = 0.68, 95% CI 0.5–0.9). Immigrant women of NESB reported greater psychological distress, less emotional satisfaction with their partner and more relationship problems in the first 3 months postpartum than Australian born women. Although immigrant mothers had an equivalent level of contact with primary care practitioners in the first 3 months postpartum, they were less likely to be asked about their emotional well-being or about relationship problems by health professionals.

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Acknowledgements

We are extremely grateful to all of the women taking part in the study; to members of the Maternal Health Study Collaborative Group (Christine MacArthur, Jane Gunn, Kelsey Hegarty, Shaun Brennecke, Peter Wein, Jane Yelland) who contributed to the design of study instruments and/or interpretation of data presented in the paper; to Ellie McDonald and Ann Krastev who played a major role in recruitment of the cohort and establishment of data management and follow-up procedures for the cohort; to Judith Lumley and Lyn Watson who contributed to the development of the study protocol; to Creina Mitchell who assisted us in the early stage of planning recruitment methods; and to members of the Maternal Health Study research team who have contributed to data collection and coding (Marita Baum, Liesje Brice, Mary Conellan, Maggie Flood, Kay Paton, Renee Paxton, Susan Perlen, Martine Spaull, Hannah Woolhouse).

Author information

Authors and Affiliations

  1. Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Melbourne, VIC, Australia

    Nirosha Lansakara, Stephanie J. Brown & Deirdre Gartland

  2. Department of General Practice and School of Population Health, University of Melbourne, Melbourne, VIC, Australia

    Stephanie J. Brown

Authors
  1. Nirosha Lansakara
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  2. Stephanie J. Brown
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  3. Deirdre Gartland
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Corresponding authors

Correspondence to Nirosha Lansakara or Stephanie J. Brown.

Appendix 1

Appendix 1

Survey Items Assessing Urinary Incontinence

  1. 1.

    Since the birth have you leaked even small amounts of urine:

    1. (a)

      when you coughed, laughed or sneezed, or did physical exercise

    2. (b)

      when you were on the way to the toilet

    3. (c)

      when you had to wait to use the toilet

    4. (d)

      if you did not go to the toilet immediately

(0 = never, 1 = less than once a month, 2 = one or several times a month, 3 = one or several times a week, 4 = every day)

  1. 2.

    Since the birth, have you ever felt an urgent need to urinate which was accompanied by a fear of leakage?

(1. No never , 2. Yes, sometimes)

Survey Items Assessing Fecal Incontinence

  1. 1.

    Since the birth, have you ever, even very occasionally, experienced leakage of solid bowel motions at an inappropriate time or inappropriate place?

(0 = never, 1 = less than once a month, 2 = one or several times a month, 3 = one or several times a week, 4 = every day)

  1. 2.

    Since the birth, have how ever, even very occasionally, experienced leakage of liquid bowel motions at an inappropriate time or inappropriate place?

(0 = never, 1 = less than once a month, 2 = one or several times a month, 3 = one or several times a week, 4 = every day)

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Lansakara, N., Brown, S.J. & Gartland, D. Birth Outcomes, Postpartum Health and Primary Care Contacts of Immigrant Mothers in an Australian Nulliparous Pregnancy Cohort Study. Matern Child Health J 14, 807–816 (2010). https://doi.org/10.1007/s10995-009-0514-x

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  • DOI: https://doi.org/10.1007/s10995-009-0514-x

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